3 months course of antibiotics

[redsquirrel]

I finally took ds1 to see a dermatologist for his acne. He's been on adaptalene for about 5 weeks and now we had to make a decision. It was either a 3 month course of antibiotics first and then assess and possibly try accutane (and I know accutane has a different name, but even the derm called it accutane so...) or just start with accutane.

 

There was no 'one is better in this situation'.  The derm left it up to me,  so I decided to go with the antibiotic first and then try the accutane if needed. DS1 already struggles with dry skin and rather torturous winter eczema, so I figured it was better to hold off on the accutane until at least milder weather, and maybe the antibiotic will help and we won't need the accutane. 

 

So, two months of 2X daily Doxycycline and then one month of 1X daily.  He just started on Friday and so far he has had no difficulty. We were warned of upset stomach,but that hasn't happened so far.

 

DS1 tends to have a very strong constitution. He doesn't get sick often and when he does it is mild. He rarely has stomach upset or digestive problems.  But, I am seriously worried about what 3 months on an antibiotic are going to do to his flora and fauna, lol. 

 

I have access to probiotics, he regularly consumes keffir, kimchi, and naturally fermented pickles and sauerkraut. But does it really make sense to keep giving him probiotics in pill form when he's taking the antibiotic?

 

This is only the second time he's ever had antibiotics, and it was a really hard decision to put him on them. But, his skin is also a painful mess and its not getting any better no matter what we do. We are trying to reduce the acne and minimize scarring.

 

Oh, and another thing: the derm told us that doxycycline will perform better if it isn't taken at the same time as 'calcium'.  Then he started talking about dairy products. He said ds1 should switch to non-dairy milk for his cereal. I was thinking that there are quite a few cereals on the market that have more calcium than the milk they are in...and our almond milk has plenty of calcium in it, possibly more than milk.  So, I am going to do my own research on this, but anyone have any reliable information to share.

 

And we did take him off dairy etc many time and it made no difference in his skin. I can pretty much say that whatever it is you are going to tell us to try instead of the medication is something we have already tried.  It seems to run in DH's family.  My BIL and his son both had severe acne. I'm over it. We needed to try something different.

[Kassia]

My dd just started on doxycycline for dermatitis.  She is taking 50mg/day and will be taking it for four months.  I do have her on probiotics, but I want to avoid a yeast infection.  She has suffered from eczema since she was an infant and we've never figured out what causes it.  Fortunately, she rarely takes antibiotics - it has to be years since the last time she did, so I'm not too concerned even though I'd prefer she not take them.  She's had no stomach upset so far (it's been about ten days since she started), but she said she "can tell" she's taking the meds.  She avoids consuming anything with calcium within a few hours of taking the meds as well.

 

 

ETA - I hope the doxycycline helps your son!  Having skin issues is very tough physically and psychologically.  :(  

 

 

Edited January 23, 2017 by Erica H

[TCB]

I think you are doing the right thing. Doxy did not work for dd, but we tried it. She is now on Accutane and I sure hope this works. Her dermatologist assures us it will. It is really, really drying out her skin and her acne has become a lot worse, but we keep saying short term cost for long term gain. I think it is good to try the different options, but I wish we had just gone ahead and taken the accutane ages ago. Unlike you, we kept trying lotions and potions for ages when we could see they didn't really work. We even tried the antibiotics twice! Sure hope this works for your son. I know how difficult skin things are for teens.

[prairiewindmomma]

I think doxy is worth a try. I'd keep dosing with probiotics, at the mid-point between antibiotic doses.

[redsquirrel]

Thank you for the support.  I really really can't take the judgement on this right now. It wasn't an easy decision and if one more person tells us to try going gluten free I'm gonna scream. 

 

And I also have the mother guilt that I haven't done anything about this sooner. BUUUUT I needed to know with certainly that the acne wasn't due to poor teenage hygiene or his being too laxidasical, or easily solved with dietary changes etc.  He has been so good for so long and tried so many things and it's just got worse or stayed the same.  He just needs some relief, poor kid.

 

Ok, so probiotic midway during the day. I can do that.

 

sheesh, I just realized I feel guilty for not doing enough and guilty for putting him on medication.  Yeah, needing to get over it, lol

Edited January 23, 2017 by redsquirrel

[regentrude]

We had done doxy for six months or a year, combined with topical benzoperoxide.

On the positive: no side effects, no digestive upset, no yeast infections.

On the negative: did not really help. We ended up with isotretinoine (accutane) for 9 month or so, and that finally helped. No side effects there either except for a bit dry skin. Wish I had done it sooner - I was concerned about the negatives..

[SebastianCat]

My DS started seeing a dermatologist about 6 months ago, and the treatment consisted of an antibiotic (minocycline, rather than doxycyclene) plus two topical meds, Tazorac and Aczone.   His acne got worse before it got better, but we started seeing a huge improvement about 6 weeks into the treatment.   We continued all 3 meds for about 3 months, then at our last follow up appointment I asked if he could discontinue the oral antibiotic and just continue with the topical meds.  The dermatologist agreed with the caveat that if his acne does get worse, I should call and get a refill of the oral meds.    We have also discussed accutane as a possibility, but I'd rather not pull out the "big guns" unless absolutely necessary.   

 

My DH had horrible acne as a teenager, and said he tried every medication in use at the time, and nothing helped.  He thinks he would have been an excellent candidate for accutane if it had been available at the time.

 

So far, we've been very pleased.   I could tell that the oral antibiotic did have an effect, and hopefully we can stay in "maintenance" mode from now on.   I had the same concerns about using an antibiotic for such an extended period of time, but they really did make a difference.

[redsquirrel]

My DS started seeing a dermatologist about 6 months ago, and the treatment consisted of an antibiotic (minocycline, rather than doxycyclene) plus two topical meds, Tazorac and Aczone.   His acne got worse before it got better, but we started seeing a huge improvement about 6 weeks into the treatment.   We continued all 3 meds for about 3 months, then at our last follow up appointment I asked if he could discontinue the oral antibiotic and just continue with the topical meds.  The dermatologist agreed with the caveat that if his acne does get worse, I should call and get a refill of the oral meds.    We have also discussed accutane as a possibility, but I'd rather not pull out the "big guns" unless absolutely necessary.   

 

My DH had horrible acne as a teenager, and said he tried every medication in use at the time, and nothing helped.  He thinks he would have been an excellent candidate for accutane if it had been available at the time.

 

So far, we've been very pleased.   I could tell that the oral antibiotic did have an effect, and hopefully we can stay in "maintenance" mode from now on.   I had the same concerns about using an antibiotic for such an extended period of time, but they really did make a difference.

 

I just remembered he is also getting the Tazorac. The pharm didn't have it and it will come in this week. He is also to use that along with the adaptalene.  I'm not even sure what that is at this point, lol.  I have a handout from the derm I will read.

 

The derm first said he wanted antibiotics first, but then changed to tell us that if we wanted to jump right to accutane that was fine with him,  So he left it up to me. I figured that that since the antibiotic will make ds1 even more photosensitive than the accutane better to use it in the dark of winter and try the accutane in the spring when the air isn't so dry.  DS1 is excellent about using sunscreen (we are an extremely pale family, lol) but might as well reduce the risk as much as possible. And yes, we all take our vit D.

 

This is the same exact course of meds that dh got for lyme disease. It also cleared up his gum disease, so maybe ds1 will find it helpful for his skin.

 

 

[edelweiss]

I think it is worth a shot to try the oral antibiotics.  I think it is quite likely that you will end up going the Accutane route but then you will know that you explored all of the options.  

 

I ended up taking Accutane after several years of antibiotics.  It worked wonders for me.  My older daughter has done a course of Accutane.  It worked really well for a while, but now she is breaking out quite a bit again.  She will likely do another course of Accutane soon.  

[Harriet Vane]

Re probiotics--

 

YES, absolutely take the probiotics for the full course of antibiotic treatment as well as for a couple months after. (Not shouting, just emphasizing.)

 

I say this as someone who has had two massive, major reactions to antibiotics, one of which was life threatening. I am not allergic to antibiotics. Both of my reactions were specifically because when the antibiotics stripped down my system, a superbug had a clear field to wreak havoc. 

 

Simply don't take the probiotics at the same time as the antibiotic. Take them at a different time of day. If he takes an antibiotic in the morning, then give a probiotic 2-3 hours later. 

 

Make sure one of his probiotics is s boulardii (Florastor) as it specifically counteracts c diff.

[Jan in SC]

My oldest did a course of accutane after he tried everything else. He was miserable with the acne and didn't want to do anything. He is so much happier now. He had very dry lips, and some joint pain, but not much. His skin looks great. If it comes back, I wouldn't hesitate to use it again.

[redsquirrel]

Thank you all so much.  I did have him take a probiotic this afternoon with his pre-ballet snack. That is a reliable routine, so it will be easy to make sure he gets his probiotic then. I also picked up the bouldarii at Amazon and should have that soon.  And thanks for letting me know about the timing. I knew probiotics were important after a antibiotic, but I didn't know if taking them during a course was useless.

 

I have never had acne so I had no idea just how difficult this is. It is a real lifestyle, sheesh.

[kewb]

Thank you for the support. I really really can't take the judgement on this right now. It wasn't an easy decision and if one more person tells us to try going gluten free I'm gonna scream.

 

 

You have to go gluten and dairy free. You should probably also eliminate soy. I am sure there is also an essential oil for this. And don't forget to take apple cider vinegar with cinnamon. 😉 Although, to be fair, the acv and zinc have helped my kids but they don't have the level of acne that requires accutane.

 

No reason to feel guilty for trying to help your son. Definitely take the probiotioc 2-3 hours after a dose. Also, you need to stay out of the sun when on doxy.

[sbgrace]

I'd consider Florastor probiotic, because the antibiotic can't kill it. It's a beneficial yeast, so yeast protective too.

 

Any damage to flora and fauna is happening quickly, so longer course is not a big deal in my mind.

 

I hope it helps. If not, you'll know you tried.

 

If not, I did Accutane as a teen, and it did help me for a long time but, for me, wasn't a permanent fix.

Edited January 24, 2017 by sbgrace

[AK_Mom4]

And.... the sun exposure warning on the Doxy bottle is not a joke. After about a month, many people get very sun sensitive and burn easily.

 

DD23 was on doxy early on in college and doing marching band in the full noon sun. She went through bottles of sun screen to avoid burning, but it was worth it.

 

We jus used a plain acidophilus probiotic (blueberry flavored if I remember right) when the kids were on doxy. Three of my four kids needed accurate (inherited horrible acne from their dad). My oldest was able to control the acne with just doxy and the topical crime.

[Carol in Cal.]

Be aware that some  people get depression from doxy.  It's not a warning on the labels, but if you nose around on the internet there is a lot of anecdotal evidence of this.  It's not super common, but just something to keep an eye out for.

[ktgrok]

My son had significant improvement on the doxy...but yes, watch out for sun sensitivity. He doesn't have that much of an issue on it, but I do when i've had it for other reasons. 

[Kassia]

And.... the sun exposure warning on the Doxy bottle is not a joke. After about a month, many people get very sun sensitive and burn easily.

 

 

 

Do you know how long the sun exposure is a problem after discontinuing the Doxycycline?  My dd will finish taking it about a week (four month dosage) before we leave for a beach vacation.  

[ktgrok]

Do you know how long the sun exposure is a problem after discontinuing the Doxycycline?  My dd will finish taking it about a week (four month dosage) before we leave for a beach vacation.  

 

I want to say it's about a week? Not sure though. But it definitely continued after finishing. I was all angry that my favorite brand of sunscreen must have changed the formula because I burnt so badly and then realized I'd been taking antibiotics. Duh. 

[redsquirrel]

You have to go gluten and dairy free. You should probably also eliminate soy. I am sure there is also an essential oil for this. And don't forget to take apple cider vinegar with cinnamon. 😉 Although, to be fair, the acv and zinc have helped my kids but they don't have the level of acne that requires accutane.

 

No reason to feel guilty for trying to help your son. Definitely take the probiotioc 2-3 hours after a dose. Also, you need to stay out of the sun when on doxy.

 

:svengo: lol  Yeah, that about covers what we've been told...even when we didn't ask  :toetap05:

 

 

We are very serious in this house about sun protection.  The derm was actually very impressed by ds1s skin, being so pale but free of freckles and sun spots.  Last August, ds1 had an ear infection and we ended up in the walk in clinic.  The doctor asked if ds1 swims a lot.  Yes, in fact we do. We belong to an outdoors private swim club (not as fancy as it sounds, lol) and the doctor asked why if we were at the pool most days doesn't ds1 have any sort of tan, lol.  Well, that is how seriously we take sun protection.

 

For the winter ds1 is using Cetaphil 50 spf daily moisturizer for his walk to school.  When it gets warmer he will switch to biore sunscreen, which is my favorite, but it isn't a moisturizer. 

 

https://smile.amazon.com/Biore-Sarasara-Watery-Essence-Sunscreen/dp/B00LA6QEOE/ref=sr_1_1_s_it?s=beauty&ie=UTF8&qid=1485278882&sr=1-1&keywords=biore+sunscreen

 

I generally have 4-6 of these in the house at any given time. It is that good.  It's tiny, so for face only. We use something else for body sun protection